SCale Down Quarterly Update – Spring 2016


SCale Down Quarterly Update

SCale Down has become the unifying link for obesity prevention efforts across the state by creating multiple opportunities for partners to connect and collaborate.  As the initiative begins its second year, the partners involved in this comprehensive effort anticipate continued progress on the work to advance the South Carolina Obesity Action Plan objectives and welcome opportunities to expand the initiative’s reach and message through new partnerships and professional networks.

Highlights of Key Efforts in Obesity Prevention

The Scale Down teams and workgroups focus their efforts on achieving the action plan objectives so that the healthy choice is the easy choice for all South Carolinians.  Through their work, innovative approaches are being developed and implemented to address the obesity epidemic in our state.  During the first quarter of 2016, many partners reported positive outcomes, promising plans for program expansion and new opportunities for collaboration in the coming year.  Highlights of these successful efforts are summarized below.

The South Carolina Fruit and Vegetable Outlet Inventory and Map

Obtaining accurate, up-to-date information on the number of farmers’ markets and roadside markets in the state, along with having more detailed information on those markets accepting food and nutrition assistance benefits, like SNAP/EBT, WIC and senior vouchers, has been a long-time challenge for the state.  In early 2015, partners from the South Carolina Department of Health and Environmental Control (SC DHEC), the South Carolina Department of Agriculture, the South Carolina Department of Social Services and the South Carolina Association of Farmers’ Markets formed a Work Group to discuss this challenge and develop a tool to obtain this needed information.

As the Work Group partners began meeting, the importance of not only developing a tool but also maintaining an inventory was stressed.  SC DHEC’s regional community health staff were approached about conducting the inventory on a regular basis, which would provide infrastructure resources and a system for sustainability.

The South Carolina Fruit and Vegetable Outlet Inventory was developed to identify farmers’ markets and roadside markets (farm stands) with predictable locations and hours where fruits and vegetables are sold throughout the state.  SC DHEC regional community health staff conducted the South Carolina Fruit and Vegetable Outlet Inventory at the local level.  Two hundred and twenty-nine inventories were conducted throughout April, May and June 2015.

The information collected through the inventory was analyzed as part of larger evaluation efforts in the state to better understand the impact fruit and vegetable outlets have on improving access to healthy foods.  An Overview of the South Carolina Fruit and Vegetable Outlet Inventory can be accessed here. The 229 outlets identified have been mapped to include detailed information about the outlets and promote locations where community members can purchase fresh fruits and vegetables.  The statewide GIS map can be found at this link.

Results from the inventory are included as part of SCale Down and the SC Obesity Action Plan.  The information obtained from the inventory will also help the Work Group partners identify areas of the state with minimal access to markets for purchasing healthy fruits and vegetables and focus priorities on improving access in those underserved areas.

Using feedback from SC DHEC regional community health staff and lessons learned from the 2015 Inventory, Work Group partners are now planning for the 2016 South Carolina Fruit and Vegetable Outlet Inventory.

For more information about the project, please contact Teresa Hill, DNPAO Healthy Eating Consultant, at

The South Carolina Breastfeeding Friendly Child Care Designation

The South Carolina Program for Infant/Toddler Care (SCPITC), with support from the SC Department of Social Services, Division of Early Care and Education and in partnership with MUSC Boeing Center for Children’s Wellness, has established a SC Breastfeeding Friendly Child Care (BFCC) designation to recognize child care programs that promote, protect and support breastfeeding.  A BFCC committee has been formed to develop and guide the designation process and includes representatives from the SC Department of Health and Environmental Control Women Infant and Children (WIC) Nutrition Program, SC Breastfeeding Coalition, SC Child Care Licensing, LaLeche League, ABC Quality Rating and Improvement, Team Nutrition and the SC Birth Outcomes Initiative.  The BFCC committee used the Carolina Global Breastfeeding Institute and the Indiana Perinatal Network child care designation model to develop the framework used in South Carolina.  There are ten criteria that child care providers must meet in order to receive the BFCC designation.  In an effort to impact the practices and culture of child care programs, one of the most important criteria calls for all child care staff in a program, from the director and infant teachers to the PreK teachers and the cook, to participate in a 2.5 hour training.  The training provides important information about storing, handling, preparing and serving breastmilk.  The training is delivered by an SCPITC Infant/Toddler Specialist paired with a community lactation expert and is offered at no cost to the child care provider.

The application to apply for this special designation was opened to child care programs in November 2015.  The winter was spent increasing awareness of the BFCC designation with presentations delivered within the state and nationally.  The BFCC Review Committee meets quarterly to review applications and award the BFCC designation.  The initial review meeting was held in January, and the Cutler Jewish Day School in Columbia was awarded the first Breastfeeding Friendly Child Care designation in South Carolina!  Additional child care programs across the state are currently working to complete the BFCC criteria, with plans to submit their applications in the next review cycle.  To learn more about the SC Breastfeeding Friendly Child Care designation, visit SCPITC.  Child care programs interested in starting the ten step process are encouraged to contact SCPITC at 843-876-2825 or

The Diabetes Advisory Council and the South Carolina Comprehensive Diabetes Prevention Plan

The Diabetes Advisory Council of SC (DAC) was reconvened on September 23, 2015 to lead the development of the Statewide Comprehensive Diabetes Prevention Plan.  The plan will provide the course of action South Carolina will take to expand the National Diabetes Prevention Program across the state.  The DAC is structured to address the four pillars of diabetes prevention and cross-cutting areas such as communication, cultural competence and evaluation.  The four pillars are:

  • Pillar 1: Increase clinical screening, testing, and referral to the National Diabetes Prevention Program (National DPP)
  • Pillar 2: Increase the availability of National DPPs
  • Pillar 3: Increase participation in the National DPP
  • Pillar 4: Increase health plan and employer coverage of the National DPP

The work of the DAC is directly related to 3 objectives in the SC Obesity Action Plan:

  • H 2.2 – Medicaid and SC private insurers will reimburse health care providers for best practices (e.g., CDC’s diabetes prevention program) and/or an evidence-based lifestyle intervention program for overweight and prevention of obesity.  Linked directly to the National DPP Pillar 4.
  • H2.5/H2.6 – Increase the number of active diabetes prevention program (DPP) sites for the primary prevention of type 2 diabetes.  Linked directly to the National DPP Pillar 2.

Workgroups and committees have been established to develop objectives and activities which will serve as the foundation for the Statewide Comprehensive Diabetes Prevention Plan in South Carolina.  The plan will be launched on April 25, 2016.  The Diabetes Advisory Council is serving as the “backbone organization” for the Statewide Comprehensive Diabetes Prevention Plan.  DAC is comprised of several statewide partner organizations, many represented on SCale Down, collaborating to create a sustainable network of health care providers and community organizations that can provide evidence-based diabetes prevention programs and champion diabetes prevention in South Carolina.  For more information, please contact Sharon Harris, DAC Coordinator, at 803-898-1631 or

A Healthier State House

SC Hospital Association’s (SCHA) Working Well Initiative has been successfully building cultures of wellbeing in hospitals and a cross sector of worksites throughout SC since 2011.  A recent partnership with SC DHEC, A Healthier State, has allowed for a cohort of state agencies, inclusive of the Governor’s cabinet agencies, to receive specialized resources and assistance to implement strategies that focus on policy, environment and benefits to support healthy behaviors among state employees.  Aligning with the objectives in the SC Obesity Action Plan, building on the success of A Healthier State and the energy amongst the SC state legislators generated by Rep. Neal Collins, there is a unique opportunity to provide a program that can develop healthy behaviors among the SC General Assembly allowing them to lead by example.  This new program is known as A Healthier State House.

Due to the growing prevalence and negative health impacts of physical inactivity, A Healthier State House focuses on fitness, but also includes elements of nutrition, achieving a healthy weight and pursuing optimal health.  Through services provided by a network of partners, there are individual resources available, as well as organizational assistance for implementing policy and environment changes that establish a culture at the State House where healthy eating and active living are the easy choices.  Thanks to Fitbit and a collaborative partnership with SCHA, the Alliance of YMCAs, Palmetto Health, Providence Hospitals, Hilton Head Hospital, Eat Smart Move More SC, SC Departments of Health and Environmental Control and Parks, Recreation and Tourism, and YMCAs across the state, participants have access to education, health assessments, onsite opportunities for physical activity and heathier food, as well as other resources.  A Healthier State House will run throughout the 2016 legislative session from mid-January to early June 2016.

“The idea [for A Healthier State House] was just one of several things I and other guests discussed during the SC Institute of Medicine and Public Health (IMPH), Health Policy Fellows panel discussion on combatting obesity,” Rozalynn Goodwin, SCHA VP of Community Engagement Goodwin explains.  “Rep. Neal Collins, who was in the audience, sent a tweet to confirm his participation.  I had no idea he would immediately begin to recruit his colleagues to join him.  This would never have taken off so quickly if he hadn’t stepped up to champion the idea,” she added.  “And we appreciate the enthusiastic support of our partners to make this effort possible.”

“We want to set an example for all South Carolinians.  Healthier food choices and more physical activity can prevent heart disease, cancer, diabetes and other diseases that rob South Carolinians of a quality life and cost all of us a lot of money,” Rep. Collins said.  “As part of the challenge, more than 100 of South Carolina’s state lawmakers will be taking steps towards better health with the help of Fitbit.  Using their activity tracker Fitbit One, along with the software and services provided by Fitbit Wellness, we’ll be able to engage in some healthy competition, encourage each other’s progress and stay active as a community.”

The initial energy has turned into action.  Participants are speaking highly of the healthier meal options, taking advantage of onsite yoga and bootcamp classes, challenging each other to Fitbit competitions, increasing their steps, active minutes and stairs, and are seeing results.  A mapped walking trail on the State House grounds is also in the works.  Almost two months in, reports of increased energy and activity levels complemented by decreasing waist lines are inspiring others.  Click here to view a participant list and a Fitbit leaderboard updated weekly.

“We are uniting the General Assembly in a healthy way, helping State leaders lead by example,” said Jen Wright, Director of Working Well at SCHA.  “By increasing access and opportunity, providing skill development, connecting with existing benefits and encouraging healthy eating and active living through motivating challenges, we hope to instill sustainable health behaviors and a culture of wellbeing at the State House.”

Connecting the Dots

Significant progress is being made to advance the 74 objectives in the South Carolina Obesity Action Plan.  The dedication and collaborative spirit of a diverse array of partners and stakeholders are the fundamental reasons for this success.  Many thanks to all the partners who continue to work diligently on policy, systems and environmental changes that are making SC communities healthier places to live, learn, work and play.  As SCale Down moves into its second year, it is essential that our state maintain this positive energy and collective momentum.  Working together, the ambitious goal of reducing and preventing obesity in the Palmetto State will be achieved!

To find out how you can get involved with SCale Down, please contact  To learn more about SCale Down, visit

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© 2015 South Carolina Institute of Medicine and Public Health